Inspection on 15/12/09 for Maple House

This is the latest available inspection report for this service, carried out on 15th December 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Maple House 15 Mill Drive Ratby Leicester Leics LE6 0JH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 1 5 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Maple House 15 Mill Drive Ratby Leicester Leics LE6 0JH 01162386302 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): kings.care@btconnect.com Kings Residential Care Homes Ltd Name of registered manager (if applicable) Peter Culshaw Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability Code LD Date of last inspection Brief description of the care home 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. We, as it appears throughout the Inspection Report, refers to The Care Quality Commission. The inspection process consisted of pre planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self assessment tool completed by a representative of the service. We have sent surveys to people who use the service along with staff and the ones we got back were very positive regarding the standard of care with only comments about the need for more training and staff supervision, which are being followed up by the Manager. The unannounced site visit commenced on the 15th December 2009 and was carried Care Homes for Adults (18-65 years) Page 5 of 27 out by Keith Charlton The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Maple. Two people who live in the home were selected. Discussions were held with the Manager and Registered Provider, four members of staff, and a relative. We were not able to communicate directly with people who live in the home due to their communication needs. Instead we observed staff practice. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Maple have had their needs properly assessed before moving into the home. Evidence: We case tracked a person living in the home who had moved in to Maple House. We checked that he had received information to help him/his relatives with the choice of home, but because the person had communication problems it was not possible to check he had received this information. The Manager stated in the AQQA that a thorough assessment is done and that they were looking at providing more accessible information for people who could not read. We also checked that people living at the home had their needs properly assessed prior to moving to Maple to ensure that the staff at the home could meet their needs. We found this to be the case as the assessment covered all important issues such as health, social history, physical ability, cognitive ability, communication etc. The Manager has also devised a transition plan to work out how it would be best to allow a new admission at the pace of a prospective new person. This charts visits to the home, culminating in overnight stays and finally admission, at the persons own Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: pace to give them the opportunity to get used to the staff and other people at the home. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of each person living at Maple are well documented and acted upon by staff. Evidence: A relative said that the care that staff provided was excellent and that she had been involved in the care planning and was fully satisfied with everything - I have never had a problem with the care here. We looked at the care records of two people living at Maple. We found very detailed plans to support the care given to people who live at the home. There was a variety of useful information available to staff - information on peoples conditions, life picture, activities file, health needs, daily living skills, self care skills etc - all written in a positive way and looking towards increasing skills and independence. Plans also detailed the mental health conditions of people and supplied detail to staff as to how to approach any challenging behavior they may meet. There is a key worker system Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: and a key workers monthly report to chart events, progress etc. There are also a number of risk assessments so that people can be protected from all identified risks. There was one issue in a Care Plan that the Manager was to follow up with the persons social worker as it was a behavioral technique that was used at his school and more fitting for a child than an adult. Staff said that they read Plans to ensure they can meet needs and keeping up to date with Plans is encouraged by management. We saw that care records were routinely up-dated to ensure they reflected the changing care needs of people living in the homes. During our visit we observed staff and management being very friendly to people and explaining what they were doing to reassure people. There was some evidence that people are able to live their own lives, e.g. going out to places in the community, choice of meal, going to meals, choice of activity, which we saw evidence of when we observed practice. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Maple have lots of opportunities to have a varied lifestyle. Evidence: We looked at the life plans of people who live at Maple. These contain details of activities recorded so that these can be checked and reviewed as needed to ensure peoples needs are met. These showed us that people are able to experience a varied social life. Some people go to College, people visit and stay overnight with parents, they go out shopping and for drives on a regular basis and the Manager said they will be able to take part in snoozelum sessions in the home to provide relaxation when this is set up, as the equipment has already been ordered. They have a variety of activities in the community to choose from. The Manager said that people are to have annual holidays and staff said that people have gone to the seaside on day trips. We saw that staff are sensitive to the needs of people living at the home. They were aware of the preferences of people in their daily activities. We saw staff talk to and interact well Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: with people who live at the home. Staff also were aware of how to effectively communicate with each person. We saw lunch time being served and people living at the home having a meal of sandwiches with a choice of two fillings. A large supply of fruit was available, which showed evidence of a healthy diet. Menus were in place and had sufficient variety. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Maple receive excellent support to meet their personal and healthcare needs. Evidence: We looked at the personal and healthcare records of people who live at Maple. We saw that they have good access to healthcare services to meet their personal and healthcare needs as described in Care Plans. On talking to a relative as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a better quality of life for those concerned. The AQAA states that there is specialist equipment to help people in their daily lives specialist bath etc, which we saw evidence of, and that people have access to specialist services - speech therapy, neurology, GP, dentist, optician, OTs etc. We looked at medication management and found that staff are administering medication appropriately to people who live at Maple, with no instances where medication was not signed as given. Records also showed valuable information Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: regarding allergies to ensure residents health is promoted. We also looked at how medication is stored and this was stored safely. We saw staff records and these showed us that staff have undertaken training in the administration of medication. We were informed that only carers are given permission to administer medication to people who live in the home when they have both passed an accredited course and been assessed as being able to issue medication correctly by the management of the home. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People, and the families of people who live at Maple can be confident that their concerns will be noted and acted upon, and they are protected from abuse. Evidence: A relative said that the Manager and Owner would swiftly act on any concerns raised: I have been impressed by how quickly things get done here. We looked at the complaints procedure and saw that this is not yet written in a format which is helpful for people living at Maple to understand though the Manager said that this is to be developed in the near future. The procedure does not give the complainant the choice to go directly to the Lead Agency if they wish, instead of the home. The Owner and Manager said this would be quickly rectified. There is a Complaints folder with one complaint that was professionally dealt with by the Manager. We saw by looking at staff training records, and by talking to staff, that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way though one staff member was unsure of all the outside agencies to refer to. Management said they would amend the short procedural statement to staff and put this to staff in a Staff Meeting process to tighten this area of practice. We also saw by looking at staff records, and by talking to staff, that they understand Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: how to work with challenging behavior. The AQAA told us that people who live in the home have their own bank accounts. Staff support people living at Maple in dealing with their money. We checked the financial records of two people living at the home, and found good recording of money transaction and a detailed daily checking procedure to ensure monies are checked and correct. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Maple live in a homely, comfortable environment. Evidence: They made the necessary adaptions for my son very quickly, said a relative. This is a new home and facilities have been refurbished to a high standard. We looked at the communal areas of the homes and the bedrooms of people who live there. We found the communal areas to be brightly decorated and homely. The bedrooms were decorated to reflect the personalities and preferences of the people using them. The AQAA told us that people choose how they like their bedrooms to be. The Manager talked about how maintenance is followed up swiftly and we saw that the home was well maintained. The garden to the rear is kept in an attractive condition, with garden furniture there so that people can use it in good weather, and has a trampoline, spa hut and is to have a vegetable garden. The Manager said there were also plans to install a snoozelum the near future. The water pressure is low, which means that it takes a long time to fill a bath and then water becomes tapid for people who want to enjoy a hotter bath. The Owner said Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: this would be looked at again to try to rectify it. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have good staffing levels and support from a motivated staff team. Evidence: There is no problem with a lack of staff, a relative said. The staff rota indicated that when all people were in the home, there were a minimum of three care staff on duty with two awake staff members at night, with an extra staff member on duty when people went out as there has to be at least two staff per person when using transport. We saw this to be the case. We talked to staff and saw them supporting people who live in the home. We saw good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. Staff staff said they were supported well to do their job by management, and there is detailed induction training and on going training relating to the job they do, and the Manager said that regular supervision will be taking place in the near future, which we found evidence of in staff records. We looked at a sample of staff records, and saw that all the necessary checks were Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken relevant training to help them in their roles though training has not yet taken place for all staff to include health and safety, infection control, fire, food hygiene, moving and handling, challenging behavior, learning disabilities, mental health issues etc - the Manager said that this would be carried out in the short to medium term. There was evidence that all staff had completed, or were doing at present, the relevant National Vocation Training to increase their skills in delivering proper care to people. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and safety systems are in place to protect peoples welfare. Evidence: The Registered Manager, Peter Culshaw, has management training and has had long service in managing care services. Peter was praised by staff for his efficient and supportive leadership. We saw Peter talking to people in a friendly fashion, interested in what they were doing. There are quality assurance systems in place regarding questionnaires that go out to people and staff and they will also go out to otherl relevant parties to ascertain views of the service so that improvements can be made if needed. The Manager said this system was to be developed so ensure that results and improvements are sought and acted upon. There are good systems in place to support staff - staff supervision is to commence in the new year and to be regular and detailed, staff meetings are frequent and include how to improve practice and help staff to strive toward the best quality practice to make sure peoples quality of life is as good as it can be. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: We checked some peoples monies records, which were found to be detailed and in order with a daily checking system in place. The AQAA informed us of the policies and procedures the service works to, to ensure good health and safety practice in the home. The temperatures of water is regularly checked to ensure people are protected from scalding water. Risk assessments are in place for safe working practices and the Manager is to look at adding to this with regard to window restrictors to keep people safe. Fire risks were seen to be covered by regular testing and a fire risk assessment being in place. The Manager was asked to look at increasing the frequency of fire drills so that staff always remember the proper fire procedure. The staff we spoke to were aware of how to properly follow the fire evacuation procedure. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 35 That staff receive all the identified necessary training, and that induction training includes learning disabilities, mental health and challenging behavior issues. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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